Diseases of Salivary Glands: Review

Alhan Al-Moula

doi:10.33899/rden.2010.9026

Abstract

The oral cavity is a moist environment, a film of fluid called saliva constantly coats its inner surfaces and occupies the space between the lining oral mucosa and the teeth. Saliva is a complex fluid, pro-duced by the salivary glands, whose important role is maintaining the wellbeing of the mouth. Patients with a deficiency of salivary secretion experience difficulty eating, speaking, swallowing as well as become prone to mucosal infections and rampant caries. In human there are three pairs of major encap-sulated salivary glands – (parotid, submandibular, and sublingual). Located outside the oral cavity, with extended duct systems to discharge their secretion. There are also a multitude of smaller minor unen-capsulated salivary glands. (labial, lingual, palatal, buccal, glossopalatine and retromolar). Located just below and within the mucous membranes, characterized by short duct systems. Secretion of each major salivary gland is not the same, the parotid glands secrete a rich amylase (watery serous saliva), whereas the submandibular gland produces mucinous saliva, and the sublingual gland produces viscous saliva. Because of these variations, saliva found in the mouth is referred to as mixed secretions, as many pro-teins are rapidly removed as they adhere to hydroxyl apatite of teeth and to the oral mucosal surfaces. Diseases of the salivary glands usually bring about changes in the rate of salivary secretion and compo-sition. These changes have a secondary effect in that they lead to the formation of a plaque and calcu-lus, which in turn has a direct bearing on the initiation of caries and periodontal disease. In addition to it, effect in the healthy condition of oral mucosal surfaces. There are many systemic conditions (e.g., diabetes, cystic fibrosis) affect salivary flows, a patient complaining of dry mouth must be thoroughly investigated. These diseases may become severe after therapeutic irradiation in and around the mouth. The salivary gland become less active with age while is problematic, because such a great variation exists in the secretion of saliva, but no longitudinal studies have thus far been reported. Even so, histo-logical changes associated with age have been reported within the salivary glands. Fatty degenerative changes, fibrosis and the progressive accumulation of lymphocytes in the salivary glands are thought to occur. Oncocytes – epithelial cells that can be identified by there marked granularity and acidophilia under the light microscope, are thought to represent as age change, although their significance has not been established, beside accumulation of structurally altered mitochondria. Oncocytes are found in acini intercalated and striated ducts of salivary glands and which may give rise to neoplasms. The aim of this review is to provide athorough knowledge of anatomy, embryology and pathophysiology in ne-cessary to treat patient appropriately. Examines the cause, diagnostic methodology, radiographic evalu-ation and management of a variety of salivary gland.

Highlights

The aim of this review is to provide athorough knowledge of anatomy, embryology and pathophysiology in necessary to treat patient appropriately
Parotid Gland: The parotid gland is the largest salivary glands, which lies superficial to the posterior aspect of the masseter muscle and the ascending ramus of the mandible.(1) The deep part of the gland may extend forward between the medial pterygoid process.(1)
The parotid gland is a lobulated mass surrounded by a connective tissue capsule, and enclosed by a dense fibrous capsule derived from the investing layer of deep cervical fascia.(1) Blood Supply: The external carotid artery and its terminal branches: 1) posterior auricular arteries, 2) superficial temporal 3) and transverse facial arteries, while the veins drain into the retromandibular vein.(1)

Summary

Introduction

Anatomy of Salivary Glands (Figure 1): A BParotid Gland: The parotid gland is the largest salivary glands, which lies superficial to the posterior aspect of the masseter muscle and the ascending ramus of the mandible.(1) The deep part of the gland may extend forward between the medial pterygoid process.(1)The parotid gland is a lobulated mass surrounded by a connective tissue capsule, and enclosed by a dense fibrous capsule derived from the investing layer of deep cervical fascia.(1) Blood Supply: The external carotid artery and its terminal branches: 1) posterior auricular arteries, 2) superficial temporal 3) and transverse facial arteries, while the veins drain into the retromandibular vein.(1)Lymph drainage: The lymph vessels drain into the parotid lymph nodes and the deep cervical lymph nodes.(1)Nerve supply: Parasympathetic secretomotor fibers from the inferior salivatory nucleus of the ninth cranial nerve supply the parotid gland. Postganglionic sympathetic fibers reach the gland as a plexus of nerves around the facial and lingual arteries, from superior cervical ganglia.(1) Histological feature of the Major Salivary Glands: Parotid Gland: In the parotid gland, the spherical secretory end pieces are all of serous type, and their pyramidally shaped acinar cells have a spherical, basally situated nucleus and surround a small, central lumen.

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